The Ilizarov method in infected nonunion of fractures

Thirty patients with infected non-union of long bones were treated with rad ical resection of the necrotic bone and bone transport or compression/distr action osteosynthesis. Non-union, infection, deformity, bone gap and shorte ning were all addressed simultaneously using the Ilizarov principles. There were 15 cases with bone loss ranging from 4 to 12 cm (median bone gap of 7 cm), 10 cases of stiff non-union (six of which had an associated deformity ) and five cases of mobile non-union. The median time in the Ilizarov frame was 150 days. Median follow up time after frame removal was 23.5 months. B one grafting at the docking site was only required in three cases (10%). Th ere were three cases of refracture (10%) and three cases of recurrence of i nfection (10%). The bone result was excellent in 21 patients (70%): good in three (10%), fair in none (0%) and poor in six (20%). The functional resul ts were excellent in eight patients (26.7%), good in 12 (40.0%), fair in th ree (10%) and poor in seven (23.3%). It is difficult to precisely define th e indications for preservation and reconstruction of severe injuries. The s urgical team has to take into account the length, disability, complications and cost of treatment. Patients must be aware of the limitations of functi onal results and the possible difficulty of return to work despite the reco nstructive attempt. (C) 2000 Elsevier Science Ltd. All rights reserved.